Commissioning standard: Dental care for people with diabetes

This guideline is for:

• Healthcare professionals
• Commissioners and providers
• Patient with type 2 diabetes (and their families and carers)

Recommendations outlined:

1. Individual care:
   • Impact of periodontal treatment on diabetes management:
   • Raise awareness about how intensive periodontal therapy, including scaling and subgingival professional mechanical plaque removal (PMPR), can help reduce HbA1c levels.
2. Integrated care pathways:
   • Develop local pathways to ensure timely and effective periodontal management for individuals living with diabetes.
   • This includes collaboration between dental and diabetes care providers to facilitate referrals and comprehensive care.
3. Personalised treatment:
   • Tailor dental care plans to individual needs, considering the severity of periodontal disease and the patient’s overall health status.
4. Education:

• CPD development:
  • Include the relationship between diabetes and oral health in continuing professional development (CPD) programs for healthcare providers.
• Awareness initiatives:
  • Implement programs to educate healthcare professionals and patients about the bidirectional relationship between diabetes and periodontal disease.
  • Train diabetes care teams (e.g., endocrinologists, diabetes educators, and diabetes specialist nurses) to recognise signs of periodontal disease and emphasise oral health during diabetes reviews.
• Training for dental teams:
  • Provide training to dental professionals on the specific needs of patients living with diabetes, including risk assessment and management strategies.

1. Diagnosing and managing periodontal disease:

• Regular screening
  • Ensure routine periodontal assessments for patients with diabetes to detect early signs of gum disease.
• Treatment protocols:
  • Provide appropriate periodontal treatments, such as PMPR, establish maintenance programs to manage gum health effectively.

1. Blood glucose management:

• Monitoring:
  • Recognise that effective periodontal treatment can improve glycemic management.
  • Collaborate with diabetes care teams to monitor blood glucose levels and adjust diabetes management plans as needed.

1. Complications:

• Risk assessment:
  • Identify and manage oral health complications related to diabetes, such as increased susceptibility to infections and delayed wound healing.
• Referral systems:
  • Establish clear referral pathways to specialists for complex cases requiring advanced periodontal care.

By implementing these recommendations, healthcare professionals and service providers can enhance the oral and overall health of individuals living with diabetes, recognising the critical link between periodontal health and diabetes management.

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